【摘要】：目的:本實驗旨在通過建立SD大鼠急性心肌缺血模型,來對比低氧預適應與遠隔缺血預處理兩種方式在急性心肌缺血情況下的心肌保護作用。方法:選取60只SD雄性大鼠,體重284g±56g(220g~350g),隨機分為4組,分別為1.空白對照組2.模型組3.低氧預適應組(HP組)4.遠隔缺血預處理組(RIP組)。每組都給予普通飼料喂養(yǎng)。其中第3組先予以15d低氧預適應處理,第4組建模前24h予以普通橡膠帶結扎大鼠尾部,形成遠隔肢端缺血預處理。第2組、3組、4組大鼠予以尾靜脈注射2u/kg垂體后葉素,并分別于注射后30min內(nèi)觀測心電監(jiān)護儀II導聯(lián)心電圖。實驗建模成功后24h胸腔采血測定心肌肌鈣蛋白T(Cardiac troponin T,cTnT)、肌型肌酸激酶同工酶(Creatine kinase-MB,CK-MB)、超氧化物歧化酶(Superoxidide Dismutase,SOD)和丙二醛(Malondialdehyde,MDA)、促紅細胞生成素(Erythropoietin,EPO)。取心尖部肌肉組織,甲醛固定后,石蠟包埋,制作切片,HE染色后觀察其病理學改變。結果:(1)低氧預適應與遠隔缺血預處理都具有良好的心肌保護作用;與模型組相比HP組與RIP組大鼠,心衰癥狀顯著減輕,注射垂體后葉素后心電圖顯示J點抬高不明顯,CK-MB、cTnT、MDA降低,SOD上升。HP與RIP組EPO均低于模型組,心律失常評分也低于模型組。心肌病理切片超微結果顯示:較對照組心梗面積減少,心肌細胞水腫變性減輕,結構更清晰。(2)HP組與RIP組相比心律失常評分無顯著差異(P0.05),CK-MB、cTnT、SOD、MDA較RIP組水平高,EPO顯著高于RIP組。心衰癥狀統(tǒng)計無明顯統(tǒng)計學差異。病理結構顯示心肌細胞損傷較RIP稍嚴重,梗死范圍較大,心肌組織中可見新生毛細血管生成。結論:(1)低氧預處理與遠隔缺血預適應都能為急性心肌缺血提供顯著的心肌保護作用(2)低氧預適應在降低心肌損傷標志物的水平上與心肌組織超微結構保護上弱于遠隔缺血預適應的第二保護窗口期。(3)RIP組與HP組均與空白對照組在CK-MB、cTnT上有顯著差異(P0.01)。
[Abstract]:Aim: to compare the protective effects of hypoxic preconditioning and distant ischemic preconditioning on acute myocardial ischemia in SD rats. Methods: 60 male SD rats, weighing 284g 鹵56g (220g~350g), were randomly divided into 4 groups, 1. Blank control group 2. Model group 3. Hypoxia preconditioning group (HP group) 4. Distant ischemic preconditioning group (RIP group). Each group was fed with general feed. The third group was treated with hypoxic preconditioning for 15 days, the fourth group was treated with common rubber band ligation of the rat tail 24 hours before modeling, and the distal limb ischemic preconditioning was formed. Group 2, group 3 and group 4 were injected with 2u/kg pituitrin via caudal vein, and electrocardiogram (ECG) of II lead of ECG monitor were observed in 30min after injection. Cardiac troponin (T (Cardiac troponin), creatine kinase isoenzyme (Creatine kinase-MB,CK-MB), superoxide dismutase (Superoxidide Dismutase,SOD) and malondialdehyde (Malondialdehyde,MDA) were measured 24 hours after modeling. Erythropoietin (Erythropoietin,EPO). The muscle tissue of the apical region was taken and fixed with formaldehyde, then embedded in paraffin and made into sections. The pathological changes were observed after HE staining. Results: (1) both hypoxic preconditioning and distant ischemic preconditioning had good myocardial protection. Compared with the model group, the symptoms of heart failure in HP group and RIP group were significantly alleviated. The ECG showed that J point elevation was not obvious, CK-MB,cTnT,MDA was decreased, SOD was increased, EPO in HP and RIP group was lower than that in model group. The arrhythmia score was also lower than that in the model group. The ultrastructural results of myocardial pathological sections showed that compared with the control group, myocardial infarction area decreased, myocardial cell edema and degeneration decreased, and the structure was clearer. (2) there was no significant difference in arrhythmia score between HP group and RIP group (P0.05), CK-MB,cTnT,SOD,. The level of MDA was higher than that of RIP, and EPO was significantly higher than that of RIP. There was no statistical difference in symptoms of heart failure. The pathological structure showed that myocardial cell injury was a little more serious than RIP, the infarct area was larger, and neovascularization could be seen in myocardial tissue. Conclusion: (1) hypoxia preconditioning and distant ischemic preconditioning can provide significant myocardial protection for acute myocardial ischemia. (2) hypoxia preconditioning can reduce myocardial injury markers and myocardial ultrastructure. (3) both RIP group and HP group were in CK-MB,. There was significant difference in cTnT (P0.01).
【學位授予單位】：川北醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R654.1

【參考文獻】

相關期刊論文 前10條

1 劉琪琳;陳斌;楊小霖;向太;魏蜀亮;;強化胰島素治療對體外循環(huán)炎癥反應的影響[J];中國老年學雜志;2015年13期

2 ;急性ST段抬高型心肌梗死診斷和治療指南[J];中華心血管病雜志;2015年05期

3 李世琪;阮倩;李羽;;低氧預處理在神經(jīng)外科手術中的腦保護作用[J];臨床麻醉學雜志;2015年04期

4 鄢娜;馮澤國;顏光濤;岳劍虹;趙艷軍;耿娜;;重復性低氧預處理對大鼠腎缺血再灌注所致肝臟損傷的影響[J];南方醫(yī)科大學學報;2015年01期

5 張慶沙;陸曉;;遠隔缺血預適應的心臟保護作用及機制[J];心血管康復醫(yī)學雜志;2013年03期

6 趙玉偉;李法琦;李萬玉;周平;邱炯;黃妍;;促紅細胞生成素對急性心肌梗死大鼠心臟的保護作用及抗凋亡信號機制[J];中國老年學雜志;2013年04期

7 楊娜;劉邕波;熊榮生;陳華夏;劉帥洲;;心內(nèi)直視術下不同階段給予EPO對未成熟心肌的保護效果[J];山東醫(yī)藥;2011年48期

8 齊帥;宋鵬飛;;血清促紅細胞生成素與急性心肌梗死的關系研究[J];西部醫(yī)學;2010年12期

9 張春秀;黃晏;張錦;;急性心肌梗死患者血清促紅細胞生成素變化及其臨床意義[J];山東醫(yī)藥;2009年44期

10 李濤;陳瑩;李保羅;陸德琴;;大鼠整體低氧預處理減輕肺缺血再灌注損傷[J];貴陽醫(yī)學院學報;2008年06期

相關會議論文 前2條

1 馮友權;孟盡海;白潔;;氧自由基在缺血再灌注損傷中的機制研究進展[A];2009年西部麻醉學術論壇論文匯編[C];2009年

2 張鋒;陳潤芬;黃定九;周兆年;;間歇性低氧預處理對兔心肌梗死范圍影響的實驗研究[A];中華醫(yī)學會心血管病分會第八次全國心血管病學術會議匯編[C];2004年

相關博士學位論文 前2條

1 申勇立;羥基自由基破壞DNA與RNA的堿基、黃酮類化合物清理羥基自由基反應機理的量子化學研究及電子密度拓撲學分析[D];南開大學;2009年

2 董建文;間歇性低氧減輕缺血再灌注引起的心肌細胞凋亡及其機制的研究[D];中國科學院研究生院（上海生命科學研究院）;2003年

相關碩士學位論文 前8條

1 譚雄;重組人促紅細胞生成素預處理在風濕性心臟瓣膜病圍手術期心肌保護作用的研究[D];川北醫(yī)學院;2015年

2 邢柏春;低氧預處理減輕單肺通氣低氧血癥的臨床隨機對照研究[D];第四軍醫(yī)大學;2013年

3 王韋江;間歇性低壓低氧預處理對真皮下血管網(wǎng)皮片周緣血運建立的研究[D];河北醫(yī)科大學;2011年

4 宋二飛;無創(chuàng)性肢體缺血預適應對中年大鼠心肌缺血再灌注損傷的保護作用[D];山西醫(yī)科大學;2010年

5 趙強;瓣膜置換患者圍術期炎性反應和心肌損傷干預治療的初步研究[D];第四軍醫(yī)大學;2009年

6 高續(xù)明;白楊素對大鼠腎缺血再灌注損傷的保護作用[D];蘭州大學;2008年

7 陳韋;化瘀祛痰顆粒對大鼠急性心肌缺血心肌微循環(huán)的保護作用[D];遼寧中醫(yī)藥大學;2007年

8 廖暉;紅花注射液對急性心肌缺血大鼠的保護作用[D];山西醫(yī)科大學;2002年

，

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